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Notice of State Tax Lien 8,5-a 00392.9 <br />seka <br />&P-r' ..�t a Read instructions on ntwrsa side <br />Llen Serial Number <br />L,:iy Type <br />Orlglnal <br />Date 1S.Clat Security Number <br />i <br />5/04/548 <br />❑ Renewal <br />04 -25 -85 ! 507 -28 -0201 _ <br />Nebraska I.D. NO, <br />County <br />Lien F,"' ""', lspouse's Soclat Security <br />01 <br />-01 -84 thru <br />I 03 -30-84 109- 05 -84' <br />86.06 <br />�] Register of Deed Number <br />16.74 <br />4597923 <br />Hall <br />j County Clerk <br />_ <br />eUSINEU NAME AND <br />LOCATION ADDRESS <br />TAXPAYER NAME AND MAILING ADDRESS <br />BusinMK Nime <br />, 06 -30-84 49 -04 -84 <br />Name <br />Z E Place <br />- -,- <br />Gj!!yNelle Winslow <br />Street Aaaress <br />^ <br />;08-01-84 thru i <br />lSU eat or Other Mailing Address <br />__ AO Nebraska Street <br />------------------ - - - - -- <br />_ P.O. Box 411 <br />- <br />qty State <br />Zl- p Code <br />C+ly State Zip Coee <br />04C001ae__- NE <br />68651 <br />Osceola, NE 68651 <br />This N ,)lice of State Tax Lien is issued by the Nebraska Department of Revenue for unpaid taxes pursuant to the <br />revenue laws of the state of Nebraska. Notice is hereby given that taxes including penalties and interest, which are <br />shown below, are due from the taxpayer specified above and remain unpaid after demand. These taxes constitute <br />a lien in the county for real and personal property belonging to the taxpayer or hereafter acquired. <br />Tax �rY <br />! Dete of <br />Tax Period I Anournertt <br />Amount of Tax <br />Penalty i � <br />I i , «t D <br />Interest I Additions f Assessment w <br />Nwnber <br />� <br />101 <br />1 <br />01 <br />-01 -84 thru <br />I 03 -30-84 109- 05 -84' <br />86.06 <br />0.00 <br />16.74 <br />! 102.80 <br />104- -8 <br />-t01 4 <br />_ _ -- - - - <br />-- - -? <br />-- <br />01 <br />, 06 -30-84 49 -04 -84 <br />149.38 <br />5.00 <br />15.70_ <br />= 170.08 <br />^ <br />;08-01-84 thru i <br />01 <br />1 08 -31 -84 01 -24 -85 <br />40.64 <br />5.00 <br />3.30 <br />48.94 <br />109 -01 -84 thru <br />01 <br />09 -30 -84 111 -13 -84 <br />0.00 <br />5.00 1 <br />0.29 <br />5.29 <br />01 <br />10 -01 -84 thru <br />1 10 -31-84 112- 0_3 -84 <br />0.00 <br />- <br />5.00 <br />-- -- <br />0.15 <br />5.15 <br />i1 -01 84 t-h� �h-ru.-T- -- <br />01 <br />11 -30-84 101 -07 -85 <br />0.00 <br />5.00 <br />0.18 <br />5.18 <br />12 -01 -84 thru. <br />01 <br />j 12 -31 -84 102 -04 -85 <br />0.19 <br />5.00 <br />0.01 <br />! 5.20 <br />TOTAL <br />i 5 342.64 <br />1 hereby Certify tnat I" Nebraska <br />Depart men[ ,t Haven ,e nn p loo xun the <br />.e a taws ut the State <br />o' Nebraska r.: me doter - <br />mination of tM amount ihpwn tG: 9e dub, and 1" la[pa /n has r. <br />:en It, pay the a <br /><lua after �art+a nd. Ir <br />1-1 NUtico �:•/ State Tax <br />Lien I3 an e.tensfo. or an a /felt <oe iien <br />+t serves to Conn u9 '.he Jrin[.Iv :;< t•.. state SJ -•teresl It the of tec[!o pr iperty of 1^.9 ta.payar. <br />soon <br />r <br />Revenue <br />Agent <br />1/r <br />her1' . arer' <br />- -- -- <br />- <br />;tlr <br />Manager <br />- -- <br />�a <br />utnorla a igne ;are - - - - <br />-- - - - _- - - <br />- i.�;a --- <br />- - <br />- O to - - -- <br />I <br />FOR COUNTY OFFICIAL'S <br />USE <br />NESRASKA DEPARTMENT OF REVENUE - White and OoldenroA Cooles TAXPAYER P-k Copy COUNTY OFFICE - Canary Copy <br />4- 894,74 Rev. I at <br />Supersedes 4 . 494 73 Rer, 5 e0 <br />U <br />